Exposure Therapy for Fears and Phobias

Exposure Therapy has been shown to be the most effective anxiety
treatment for people with many anxiety disorders. You might already know
that it involves practicing with what you fear, in order to become less
afraid. But how does it work?

Exposure Therapy helps you retrain your brain. It's not just about
"getting used to" the fear. It's about retraining your brain to stop
sending the fear signal when there isn't any danger.

People
struggle against anxiety attacks and phobias because they recognize that
their fears are exaggerated and illogical. They try hard to talk
themselves out of the fear.

But that doesn't help. So they end up trying to avoid the fear, and that, unfortunately, just strengthens it.

Exposure Therapy will help you retrain your brain to let go of phobias, anxiety attacks, and other forms of anxiety disorders.

Let's see how Exposure Therapy works.

Fight or Flight

When your brain gets a signal of danger, it triggers an immediate
response, the familiar Fight or Flight response. That's a good thing,
because when we face danger, we need to react quickly and powerfully.

Humans
evolved in a different world than the one we inhabit today. It was a
world full of predators, without police or deadbolt locks. Our main job
was to get enough to eat each day without becoming food for somebody
else. We needed a good emergency alert system to keep us out of the jaws
of predators.

If we had relied on the thinking, intellectual part
of our brain, called the cerebral cortex, to keep us safe, we'd be
extinct. It's too slow. It's good for writing a speech, and figuring out
your income tax, but not for making snap decisions about danger.

The
part of your brain that handles these Fight or Flight responses is very
different from the part of the brain you're most familiar with.

The Amygdala

The Amygdala, a little almond shaped part of your brain, is what
makes these Fight or Flight decisions. The Amygdala works quickly,
without your conscious awareness, because speed is vital in protecting
against threats. You only find out what the Amydgala did when you feel
its effects in your body (all the familiar panic sensations) and in your
behavior (duck, run, escape).

Whenever we make a decision, there
are two possible kinds of errors. One is a false positive. If you decide
there's a tiger hiding in the tall grass, when there isn't one, that's a
false positive. When you make a false positive error, you get afraid in
the absence of danger, but you don't get eaten.

The second type
is a false negative. If you decide there's no tiger hiding in the tall
grass when there really is one, that's a false negative. When you make
this false negative error, you feel okay, but you're gonna get eaten.

Your
Amygdala doesn't care how many times it scares you unnecessarily. It
just aims to keep you alive. It doesn't want to make any false negative
mistakes.

If you experience phobias and anxiety attacks, and want
to overcome them, you need a form of anxiety treatment which will
retrain this part of your brain. The most direct and systematic way to
do that is Exposure Therapy.

How Your Amygdala Works

Always Watching

Your Amygdala is always watching, passively, in the background, for some
sign of danger. When it sees one, true or false, it presses the "fight
or flight" button and fills you with fear. When the danger is real,
that's a good thing. But your Amygdala works like it's still 27,000
B.C., and will often make the mistake of seeing danger when there's
none.

It Learns by Association, not Reason or Logic

When you run away from whatever the apparent danger is, the Amygdala
stands down and goes back to quietly watching. If you ran away from a
mugger, that's a good thing. But if you ran away from a grocery store,
or a dog on a leash, that's a bad thing. Now your Amygdala will be
conditioned to see the grocery store or the dog as dangerous, and will
make you afraid next time you see one.

The Amygdala learns by
association. It associates the crowded store, or the dog, with danger.
It doesn't learn by conscious thought. This is why you can't simply talk
yourself out of a phobia or anxiety attack. The fear memory is stored
as a conditioned fear, and can only be relieved by more conditioning,
not discussion or reason.

It only Learns When You're Afraid

The Amygdala only learns when it's fully activated, when it spots
something it considers dangerous. It only forms new memories and
associations, new lessons, when you've become afraid. The rest of the
time it's on autopilot, passively watching.

Do you see what this
means? If you stay away from what you fear, your Amygdala will keep on
"believing" the same old mistakes, without a chance to learn anything
new.

How Can You "Talk" to Your Amygdala?

Your Amygdala only learns from experience. If you flee the scene
every time you have an anxiety attack, your Amygdala learns that you
should leave to be safe.

How can you get your Amygdala to learn
something new? You have to activate it by exposing yourself to a trigger
that gets you afraid. If you have a dog phobia, that would be a dog. If
you have anxiety attacks on subways (or highways), you need a subway
(or a highway). And you need to stay there with that fear until it gets a
lot lower.

That gives your Amygdala the chance to learn that it
got all worked up about nothing. That way, it can learn that dogs (or
highways) aren't the threat that it had been conditioned to believe.
And, with repetition, it will develop a new memory, one that lets you
get on with your life without being disrupted by phobias and anxiety
attacks.

Retraining Your Amygdala

You
don't have to do this radically and quickly. What you need to do is to
continually arrange to activate your Amygdala by exposing yourself to
what you fear, and then stay in place, making sure that the fear leaves
before you do. You can use a variety of coping steps
to help you do that, or you can just "float", as Claire Weekes called
it, and wait for the fear to subside. Either way, Exposure Therapy will
enable you to retrain your Amygdala with new learning in ways it can
absorb.

I offer this treatment in the Chicago area, and if you're looking for help here, you can
contact
me by phone or e-mail. If you want to learn to do some of this on your own, my
Panic Attacks Workbook
will show you how.